Allwood M C
Pharmacy Academic Practice Unit, University of Derby, Mickleover, U.K.
J Clin Pharm Ther. 1994 Jun;19(3):137-45. doi: 10.1111/j.1365-2710.1994.tb00667.x.
Centralized intravenous additive services (CIVA) are becoming an essential component of hospital pharmacy services in the U.K. This review explores the background to their development, indicating how aseptic services commenced with total parenteral nutrition, developed further with cytotoxic drug preparation and is now progressing, in an increasing number of hospitals, to a full range of parenteral drug services. The benefits of pharmacy-operated provision of injections in ready-to-administer forms are described. The operation of such services is then considered in detail. A brief discussion of the types of service that can be operated is followed by consideration of staffing, facilities, methods of operation, technical support and documentation. National guidelines in the U.K. and U.S.A. are compared, since these have a major influence of the nature of CIVA service operation. The issues associated with the stability of reconstituted and repackaged injectables are discussed, together with how our knowledge can be used in the assignment of shelf lives to pharmacy-prepared intravenous additives. The review concludes with a brief assessment of future trends and changes likely to affect intravenous services provided under pharmacy control.
集中式静脉药物添加服务（CIVA）正在成为英国医院药学服务的重要组成部分。本综述探讨了其发展背景，指出无菌服务如何从全胃肠外营养开始，随着细胞毒性药物制剂的发展而进一步发展，现在在越来越多的医院中，正朝着提供全方位的胃肠外药物服务迈进。文中描述了由药房提供即用型注射剂的益处。随后详细讨论了此类服务的运作情况。在简要讨论了可开展的服务类型之后，接着考虑人员配备、设施、操作方法、技术支持和文件记录。对英国和美国的国家指南进行了比较，因为这些指南对CIVA服务运作的性质有重大影响。文中讨论了与重构和重新包装注射剂稳定性相关的问题，以及如何将我们的知识用于确定药房配制的静脉药物添加剂的保质期。综述最后简要评估了未来可能影响药房控制下静脉服务的趋势和变化。
